Healthcare Provider Details

I. General information

NPI: 1770708091
Provider Name (Legal Business Name): ANDREA GREEN HINES M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/13/2007
Last Update Date: 01/20/2026
Certification Date: 01/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

982055 NEBRASKA MEDICAL CTR
OMAHA NE
68198-2055
US

IV. Provider business mailing address

982055 NEBRASKA MEDICAL CTR
OMAHA NE
68198-2055
US

V. Phone/Fax

Practice location:
  • Phone: 402-559-4000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0208X
TaxonomyPediatric Infectious Diseases Physician
License Number5525
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number5525
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: